Reading impairments in schizophrenia relate to individual differences in phonological processing and oculomotor control: Evidence from a gaze-contingent moving window paradigm.

Abstract

Language and oculomotor disturbances are 2 of the best replicated findings in schizophrenia. However, few studies have examined skilled reading in schizophrenia (e.g., Arnott, Sali, Copland, 2011; Hayes & O'Grady, 2003; Revheim et al., 2006; E. O. Roberts et al., 2012), and none have examined the contribution of cognitive and motor processes that underlie reading performance. Thus, to evaluate the relationship of linguistic processes and oculomotor control to skilled reading in schizophrenia, 20 individuals with schizophrenia and 16 demographically matched controls were tested using a moving window paradigm (McConkie & Rayner, 1975). Linguistic skills supporting reading (phonological awareness) were assessed with the Comprehensive Test of Phonological Processing (R. K. Wagner, Torgesen, & Rashotte, 1999). Eye movements were assessed during reading tasks and during nonlinguistic tasks tapping basic oculomotor control (prosaccades, smooth pursuit) and executive functions (predictive saccades, antisaccades). Compared with controls, schizophrenia patients exhibited robust oculomotor markers of reading difficulty (e.g., reduced forward saccade amplitude) and were less affected by reductions in window size, indicative of reduced perceptual span. Reduced perceptual span in schizophrenia was associated with deficits in phonological processing and reduced saccade amplitudes. Executive functioning (antisaccade errors) was not related to perceptual span but was related to reading comprehension. These findings suggest that deficits in language, oculomotor control, and cognitive control contribute to skilled reading deficits in schizophrenia. Given that both language and oculomotor dysfunction precede illness onset, reading may provide a sensitive window onto cognitive dysfunction in schizophrenia vulnerability and be an important target for cognitive remediation.